Five Ducks Art Academy

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Name* This field is required.
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Emergency Contact's Name* This field is required.
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Phone Number* This field is required.
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Which class is your child enrolling in?
Tuesdays 5:00–6:00 PM — Creative Crew (Grades 3–5)
Wednesdays 5:00–6:00 PM — Art Lab (Grades 6–8)
Thursdays 5:00–6:00 PM — Creative Kids (Grades K–2)
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Does your child have any allergies?* This field is required.
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is your child on any medications?* This field is required.
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Does the child have any chronic illness, behavorial or medical conditions? If yes, please describe.
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I give Five Ducks Permission to photograph, videotape and/or audio my child for public relations and/or marketing purposes.* This field is required.
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I authorize Five Ducks staff in any emergency situation to administer basic first aid for health or welfare reasons.* This field is required.
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Discipline Policy see parent handbook for more details: 1. Verbal Warning and the warning will be documented. Parents will be notified at pick-up time. 2. Written Warning: A report of the incident will be written, and parents will be notified. 3. Suspension: Suspension from the camp program will be an automatic consequence for behavior such as fist fighting, physical/verbal coercion and destruction of property. No refunds or credits will be given for time missed due to disciplinary action.* This field is required.
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Payment Agreement
I understand that I will be charged $95 today ($70 tuition + $25 registration fee)
I understand that I will be charged $70 in March for the second month of the program
I understand that the registration fee is non-refundable
I understand this is an 8-week session (February–March)
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ORDER SUMMARY
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Five Ducks Craft Club Registration
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